tbuckley/cabot-search huggingface dataset:
POS0672 RHEUMATOLOGISTS OVERCALL SACROILIITIS ON X-RAY AND MRI IN AXIAL SPONDYLOARTHRITIS PATIENTS: DATA FROM THE BELGIAN INFLAMMATORY ARTHRITIS AND SPONDYLITIS COHORT (BE-GIANT)
Authors: A. S. De Craemer, M. De Hooge, T. Renson, L. Deroo, G. Varkas, L. Van Praet, R. Joos, J. Lenaerts, M. Devink, L. Gyselbrecht, I. Peene, K. Thevissen, P. Carron, F. Van den Bosch, D. Elewaut
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Imaging of the sacroiliac joints, especially with magnetic resonance imaging (MRI), is an important tool for early diagnosis of axial spondyloarthritis (axSpA). Interpretation of sacroiliac joint imaging can vary according to readers' experience, but it is currently unknown if and how imaging assessment differs between academic hospitals and community based rheumatological care. <h3>Objectives</h3> To investigate (1) agreement between local and central reading of sacroiliac joint images (X-ray and MRI) from axSpA patients, and (2) to explore potential differences between patients diagnosed in an academic hospital compared to community centres. <h3>Methods</h3> The BelGian Inflammatory Arthritis and spoNdylitis cohort (Be-GIANT) includes newly diagnosed biological-naïve axSpA patients, that fulfil the ASAS classification criteria, at the outpatient clinic of an academic hospital and eight community centres in Flanders. X-ray and MRI of the sacroiliac joints (SIJ) of patients enrolled between November 2010 and August 2020 were assessed by the local rheumatologist ('local reading') and two calibrated central readers ('central reading') for definite radiographic sacroiliitis according to the modified New York criteria (X-SIJ) and active sacroiliitis according to the ASAS/OMERACT definition of a positive MRI (MRI-SIJ). Central readers resolved discrepant cases by consensus. Inter-reader reliability was assessed with Cohen's Kappa, and % overall, positive and negative agreement. <h3>Results</h3> Among the 271 included patients (n=205 academic hospital, n=66 community hospital), 231 X-SIJ and 208 MRI-SIJ were available for central reading (Table 1). Central readers disagreed with local readers on 30/231 (13%) X-SIJ images (κ=0.44, moderate); 4/231 (1.7%) were reclassified as radiographic sacroiliitis and 26/231 (11.3%) as not showing radiographic sacroiliitis. Overall agreement was higher between central readers and academic rheumatologists compared to community rheumatologists (90.5% vs. 70.7%, p&lt;0.001). 53/208 (25.4%) MRI-SIJ images were reclassified by central readers (κ=0.36, fair); the majority as negative for active sacroiliitis (51/208, 24.5%). Central readers agreed on the assessment of MRI-SIJ in a higher proportion with academic rheumatologists versus community rheumatologists (77.2% vs. 63.4%, p=0.07). <h3>Conclusion</h3> In newly diagnosed axSpA patients, the prevalence of radiographic sacroiliitis is low. Sacroiliitis on MRI is overcalled by rheumatologists both in academic and non-academic settings, underscoring the need for continuous educational trainings. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0602-HPR MORE ACTIVITY LIMITATIONS AND LOWER QUALITY OF LIFE IN PERSONS WITH SYSTEMIC SCLEROSIS WITH THREE OR MORE SYMPTOMS THAN IN THOSE WITH TWO SYMPTOMS
Authors: H. Pettersson, S. Pettersson, M. Regardt
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SSc) is an inflammatory rheumatic disease affecting skin and internal organs (1). Little is known about how many symptoms persons with SSc (pwSSc) report ever and currently and how they impact activities and quality of life (QoL). <h3>Objectives</h3> To investigate what symptoms pwSSc report as most troublesome ever and currently and how the number of current symptoms affect activities and QoL. <h3>Methods</h3> In an SSc study at Karolinska University Hospital data were collected using open ended questions of what symptoms pwSSc considered most troublesome ever and currently. The self-reported answers were analyzed using qualitative analysis and categorized with an inductive approach. Participants answered Scleroderma Health Assessment Questionnaire, SHAQ, with the symptom severity Visual Analogue Scales, VAS, and Quality of Life, QoL, measured with EuroQoL, EQ VAS. Analysis was done to investigate what categories/symptoms pwSSc reported most troublesome ever and currently and if the number of symptoms currently present impact activities and QoL. Differences in reported symptoms ever and currently were analyzed with nonparametric tests when investigating differences between participants with 0-2 and ≥3 reported symptoms currently. <h3>Results</h3> A total of 291 pwSSc, median age 60 yrs, 83% women, participated. 254 (87.3%) pwSSc reported symptoms ever and 260 (89.3%) symptoms currently. 38,5% of the participants had three or more symptoms currently present. These pwSSc also perceived more activity limitation (p=0.006) and less QoL (p=0.023) than those with fewer symptoms. The median score of SHAQ (activity limitation) was 0,0 (0-3) and EQ VAS (QoL) was 62 (0-100) in the whole group. Among pwSSc with 0-2 symptoms currently the score of SHAQ was 0.38 and EQ VAS was 70 and in those with ≥3 symptoms the median score of SHAQ was 0,63 and EQ VAS was 70, p=0.006 and p=0.023. <h3>Conclusion</h3> PwSSc and ≥3 self-reported symptoms have a higher disease severity, more activity limitations and a lower QoL than persons with fewer symptoms. Health professionals need to focus resources on pwSSc with more reported symptoms to lessen activity limitations and improve QoL in pwSSc. <h3>Reference</h3> [1]Saketkoo LA, et al. A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc. Best Pract Res Clin Rheumatol. 2021 Sep;35(3):101707. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0512 DIAGNOSTIC AND DIFFERENTIAL BIOMARKERS IDENTIFIED BY METABOLOMIC ANALYSIS IN PATIENTS WITH PSEUDOGOUT
Authors: S. Takahashi, M. Takahashi, Y. Tanimoto, T. Yamaoka, M. Katayama, S. Hatachi, M. Shinohara, S. Kumagai
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pseudogout is an acute arthritis induced by calcium pyrophosphate dehydrate crystal deposition (CPPD) [1]. Pseudogout most commonly involves one or several large joints, such as the knee or wrist, typically tender and swollen [2]. The pathogenic mechanism of CPPD is partially understood, and the etiology of attacks is unclear. There is no diagnostic serum biomarker for pseudogout. CPPD disease is best diagnosed by identifying positively birefringent, typically rhomboid-shaped crystals in the synovial fluid of affected joints. However, CPPD disease and rheumatoid arthritis (RA) often coexist, and the similarity of pseudogout with acute flares of RA might lead to misdiagnosis. <h3>Objectives</h3> To identify the metabolites which characterize pseudogout compared with RA and to identify serum biomarkers of pseudogout using metabolomic analysis of serum and synovial fluid. <h3>Methods</h3> We collected serum and synovial fluid from 18 pseudogout patients and 12 RA patients with acute flares. We also collected serum from five pseudogout patients after resolving arthritis. We performed a metabolomic analysis of the samples using gas chromatography-mass spectrometry (GC-MS). Metabolites contributing to the differentiation between pseudogout with acute arthritis, pseudogout with resolving arthritis, and RA were determined by analysis of the orthogonal partial least-squares discriminant analysis (OPLS-DA) weightings (variable importance in the projection (VIP)&gt;1, the absolute value of modeled correlation (|p(corr)|) &gt; 0.5 in the S-plot) and Wilcoxon rank sum test (<i>p</i> &lt; 0.05). <h3>Results</h3> A total of 123 metabolites from synovial fluid and 101 metabolites from serum were identified by GC-MS. By using OPLS-DA (Figure 1) and Wilcoxon rank sum test, nine metabolites from synovial fluid and 19 metabolites from serum were selected as the metabolites that contributed to the differentiation between pseudogout and RA, and nine metabolites from serum were selected as the metabolites that contributed to the differentiation between pseudogout with acute arthritis and pseudogout with resolving arthritis. Among the selected metabolites, we identified five metabolites which characterized pseudogout compared with RA and two metabolites which elevated in pseudogout with acute arthritis compared with both RA and pseudogout with resolving arthritis. <h3>Conclusion</h3> By metabolomic analysis, we identified metabolites that differentiate pseudogout from RA and the potential serum diagnostic biomarkers for pseudogout. <h3>References</h3> [1]McCarty DJ et al. Ann Intern Med 1962;56:711-737. [2]McCarthy GM and Dunne A. Nat Rev Rheumatol 2018 Oct;14(10):592-602. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0648 EFFECT OF OBESITY ON DISEASE ACTIVITY OF PATIENTS WITH EARLY RHEUMATOID ARTHRITIS: DATA FROM A NATIONWIDE COHORT
Authors: M. K. Chung, B. H. Park, H. Park, J. Lee
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic, multifactorial, inflammatory disease, and obesity is one of the risk factors implicated in RA development. Although obesity has been recently reported to be related to disease activity and clinical response of RA, the association between obesity and disease activity of RA is still controversial. <h3>Objectives</h3> This study aimed to investigate the effect of obesity on baseline disease activity and clinical response of patients with early RA. <h3>Methods</h3> Of 5,077 patients with RA enrolled in the Korean observational study network for arthritis (KORONA) registry, a nationwide RA-specific cohort, we identified 1,178 patients with disease duration of &lt;2 years who had both baseline and 2-year follow-up data. Patients were grouped according to their body mass index (BMI): obese (BMI ≥25) and non-obese (BMI &lt;25). Baseline and 2-year follow-up disease activity markers including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), swollen and tender joints, patient global assessment (PGA), evaluator global assessment (EGA), clinical disease activity index (CDAI), and health assessment questionnaire-disability index (HAQ-DI) were compared between two groups. <h3>Results</h3> Among early RA patients, 282 (23.9%) obese and 896 (76.1%) non-obese patients were identified. The non-obese group showed higher ESR than the obese group at baseline (29.9±0.9 vs 25.6±1.6, p=0.019), and other disease activity variables showed no difference according to the obesity status. When comparing the group who maintained obese (n=176) and non-obese (n=660) for two years, the obese group had higher CRP positivity (37.4% vs 26.9%, p=0.009) while other variables including CDAI showed no significant difference between the two groups. <h3>Conclusion</h3> Obesity was not associated with baseline disease activity and treatment response of patients with early RA. As obesity was related to CRP positivity in 2-year follow-up measurements, the use of disease activity tools containing CRP requires careful attention. <h3>References</h3> [1]Sandberg ME, Bengtsson C, Källberg H, et al. Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis. Ann Rheum Dis 2014;73:2029-2033. [2]Mirpourian M, Salesi M, Abdolahi H, Farajzadegan Z, Karimzadeh H. The association of body mass index with disease activity and clinical response to combination therapy in patients with rheumatoid arthritis. J Res Med Sci 2014;19:509-514. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0681 REVISION IN TREATMENT DECISION MIGHT BE NECESSARY IN SEEMINGLY INACTIVE AXSPA PATIENTS ACCORDING TO BASDAI
Authors: D. Solmaz, H. Kocaayan, E. Durak Ediboglu, K. A. Sinci, A. Özkan, G. Kabadayi, İ. Kurut Aysin, Ö. Gerçik, E. Erpek, E. Otman Akad, H. Cinakli, O. Tosun, S. Akar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Objectives</h3> To determine the frequency of inconsistency between the BASDAI and ASDAS-CRP cut-off values in disease activity categorization in patients with axial spondyloarthritis (axSpA) and to characterize the reasons for the discordance. <h3>Methods</h3> In total 575 axSpA patients (mean age: 40.2 ± 11.5; male gender: 358, 62.3%) followed up in a single center and who had both BASDAI and ASDAS-CRP scores at the same visit were included in this analysis. Of them 369 (64.2%) were classified as radiographic axSpA (r -axSpA). A BASDAI score of ≥4 and an ASDAS score of ≥2.1 were used as the cut-off value for the differentiation of inactive/active disease state. The demographic, disease related characteristics of the patients including structural damage were obtained. <h3>Results</h3> Inconsistency in the definition of the disease state according to two composite disease activity measures was found in 146 (25.4%) patients. As a consequence, the concordance rate of the two scales was calculated as 74.6% and corresponding κvalue was 0.458. Of the 274 patients who has inactive disease according to BASDAI, 46.4% were classified as active according to ASDAS-CRP (Figure 1). In our whole group; discordant patients for the disease state distinction according to two measures <b>had higher CRP values, lower percentage of heel pain, and they were using less biologics</b>. These patients also <b>had lower BASFI, HAQ-S, and overall pain scores</b> (Table 1). When we evaluated inactive patients according to BASDAI, discordant patients were significantly <b>older, had lower education, higher serum CRP levels, and more frequently peripheral arthritis</b>. Baseline mSASSS scores were higher in those discordant patients and more patients had syndesmophyte, additionally the progression rate according to mSASSS was higher. <h3>Conclusion</h3> In daily clinical practice discordance in the disease activity definition might be observed in around 25% of axSpA patients according to two widely used composite measures. The results of the present study suggested that patients with high serum CRP levels could be easily classified as inactive according to BASDAI and those patients might have developed more structural damage in disease course. Our results suggest that those patients misclassified according to BASDAI scale had worse functional status and quality of life. In conclusion ASDAS-CRP might be more appropriate disease activity measure in treatment decision. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0721 DIFFERENT PATTERNS OF VASCULAR ULTRASOUND ARE ASSOCIATED WITH DIFFERENT ISCHEMIC COMPLICATIONS IN PATIENTS WITH GIANT CELL ARTERITIS
Authors: J. Molina Collada, G. Torres Ortiz, I. Castrejon, I. Monjo, E. Fernández-Fernández, J. M. Alvaro-Gracia, E. De Miguel
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with giant cell arteritis (GCA) can present ischemic complications (IC). Recognizing patients at risk of IC may help to improve GCA long-term outcomes. However, previous studies have failed to identify consistent risk factors for IC in this population, being mainly low systemic inflammation or atherosclerotic risk factors the main findings in some cohorts. <h3>Objectives</h3> Our objective is to determine if a specific pattern of vascular inflammation by ultrasound (US) is associated with different types of IC in patients with GCA. <h3>Methods</h3> A retrospective observational study of patients referred to the US fast track clinics of two academic centres with GCA clinical confirmation over a 4-years period. All patients underwent baseline US of cranial and extracranial arteries (carotid, subclavian and axillary) at the time of referral, and were classified in two categories; cranial or large vessel (LV)-GCA, according to US findings. IC was defined as the occurrence of acute anterior ischemic optic neuropathy (AION) or non-AION (including stroke, acute coronary syndrome, pulmonary embolism or peripheral artery disease) within 3 months after diagnosis, and after excluding other potentially implicated causes. Chi-squared and analysis of variance were performed to explore the association between clinical or US variables with the occurrence of different types of IC. <h3>Results</h3> A total of 42 (22.9%) patients over 188 patients with GCA clinical confirmation evaluated at our clinics had an IC within 3 months after diagnosis, 24 (12.8%) an AION and 19 (10.1%) a non-AION IC (10 stroke, 5 acute coronary syndrome, 4 peripheral artery disease, 2 pulmonary embolism and one case of ischemic colitis). Patient characteristics according to IC type are shown in Table 1. Patients with AION showed more frequently findings of US cranial involvement (100%) versus patients with non-AION IC (63.2%) and without IC (79.3%), p=0.009. In contrast, patients with non-AION IC presented more frequently signs of US LV-GCA (63.2%) versus patients with AION (25%) and without IC (55.2%), p=0.014). <h3>Conclusion</h3> Different patterns of vascular US involvement are associated with different IC in GCA patients. Predominantly cranial-GCA patients have more frequently AION, while predominantly LV-GCA patients have more frequently non-AION IC, as stroke, acute coronary syndrome, pulmonary embolism or peripheral artery disease. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0895 ANKLE RETINACULA ABNORMALITIES AS FEATURES OF PSORIATIC ARTHRITIS: AN ULTRASOUND STUDY
Authors: M. Forien, E. Ebstein, B. Leger, L. Benattar, P. Dieudé, S. Ottaviani
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankles are frequently involved in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) and can be observed in both diseases. The detection of enthesitis may support the diagnosis for PsA and help to distinguish theses 2 rheumatic diseases. At ankle level, retinacula can be analyzed with ultrasonography (US) and their insertions into bones can be considered as enthesitis. <h3>Objectives</h3> The aim of the present study was to compare the US assessment of the retinacula of ankles in a population of RA and PsA patients with painful ankle. <h3>Methods</h3> This was an observational cross-sectional study. We analyzed consecutive RA or PsA patients with ankle pain. We also analyzed healthy controls (HC), without rheumatic disorders nor ankle pain. The following US features were assessed: presence of synovitis of tibiotalar or talonavicular joints, presence of tenosynovitis of peroneal or posterior tibial tendons. Two retinacula: the superior peroneal retinaculum (SPR) and the flexor retinaculum (FR) were also evaluated in mode B (thickness, echogenicity and presence of malleolar periostosis) and the vascularization at their insertion into bone by using power Doppler (PD). <h3>Results</h3> We analyzed data for 80 consecutive patients (60% women; median age 56 years). Among these patients, 37 (46%), 23 (29%) and 20 (25%) were RA, PsA and HC patients, respectively. A total of 160 ankles were assessed. The evaluation of SPR did not show difference between the two diseases. Regarding the FR, we observed that FR was thicker in PsA patients than in RA (0.96mm ± 0.39 vs. 0.64mm ± 0.15, P&lt;0.001) and HC (0.96mm ± 0.39 vs. 0.56mm ± 0.12, P&lt;0.001) without difference between RA patients and HC. The following US features were more frequently found in PsA than in RA ankles: hypoechogenicity (46% vs 7%, P&lt;0.001), positivity of PD (43% vs 8%, P&lt;0.001) and malleolar periostosis (43% vs 8%, P&lt;0.001). By using ROC curve analysis, we determined that a cut-off of 1mm of FR thickness provided a sensitivity of 49% and specificity of 97% for the diagnosis of PsA. The association of a thickness ≥1mm with hypervascularization of the malleolar insertion of FR, named as "retinaculitis", was observed in 39% and 3% of ankles in PsA and RA, respectively. The proportion of retinaculitis of SPR was not different between the two diseases. <h3>Conclusion</h3> US abnormalities of FR were more frequently observed in PsA than in RA patients and appear to be specific for PsA. Thus, US assessment of FR might be useful to distinguish RA and PsA in patients with painful ankles. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS0805-HPR FACE VALIDITY AND RELIABILITY TEST OF THE DANISH VERSION OF THE COMPLIANCE QUESTIONNAIRE RHEUMATOLOGY
Authors: L. Raunsbæk Knudsen, A. De Thurah
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Medication adherence in inflammatory arthritis has been reported to vary from 30% to 80%, despite the fact that non-adherence may cause worsening of symptoms and disease severity [1]. Hence, supporting adherence to medication is an essential part of the treatment and care of patients with rheumatic and musculoskeletal diseases [1]. The Compliance Questionnaire Rheumatology (CQR) measures adherence in rheumatic diseases through 19 items covering drug-taking behaviour to identify the factors that contribute to suboptimal adherence [2]. <h3>Objectives</h3> To present the translation of the CQR into Danish and the face validity and reliability test. <h3>Methods</h3> The CQR was translated into Danish according to the International Quality of Life Assessment method (3), which involved forward and backward translations by four independent translators, followed by a face validity test among 10 patients with rheumatoid arthritis. The test–retest reliability of the Danish CQR was evaluated in 49 patients with rheumatoid arthritis using the standard error of the measurement (SEM) converted into the minimally detectable change (MDC) and the intraclass correlation coefficient (ICC). Questionnaires were administered with a minimum of 10 days between assessments. <h3>Results</h3> The face validity test did not lead to substantial corrections. The participants in the reliability test had a mean age of 57.4 years (SD 16.1) and a mean disease duration of 1.13 years (range 2 months–2 years). The mean CQR score in the test and retest was 62.69 (confidence interval (CI) 58.76; 66.63) and 62.51 (CI 58.91; 66.12), respectively, with a SEM of 8.59 (7.16; 10.73) and a MDC of 16.83. A satisfactory test–retest reliability was confirmed by an ICC value of 0.79 (CI 0.68; 0.89) (Table 1). <h3>Conclusion</h3> The Danish CQR has satisfactory test–retest reliability in patients newly diagnosed with rheumatoid arthritis and is thus considered a reliable tool to measure adherence in this group. <h3>References</h3> [1]Ritschl V, Stamm TA, Aletaha D, Bijlsma JWJ, Böhm P, Dragoi RG, et al. 2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice. Ann Rheum Dis. 2021(80). [2]de Klerk E, van der Heijde D, van der Tempel H, van der Linden S. Development of a questionnaire to investigate patient compliance with antirheumatic drug therapy. J Rheumatol. 1999;26(12):2635-41. [3]Bullinger M, Alonso J, Apolone G, Leplège A, Sullivan M, Wood-Dauphinee S, et al. Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment. J Clin Epidemiol. 1998;51(11):913-23. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Line Raunsbæk Knudsen Speakers bureau: Novartis, Phizer, Eli Lilly, Annette de Thurah: None declared.